title: Neuron-specific enolase, S100B, and glial fibrillary acidic protein levels as outcome predictors in patients with severe traumatic brain injury.
abstract: BACKGROUND
  The availability of markers able to provide an early insight related to prognostic and functional outcome of patients with traumatic brain injury (TBI) are limited.
  
  
  OBJECTIVE
  The relationship of clinical outcome with CSF neuron-specific enolase (NSE), S100B and glial fibrillary acidic protein (GFAP) levels in patients with severe TBI was investigated.
  
  
  METHODS
  Twenty patients with severe TBI (7 days at unit care) and controls were studied. Patients were grouped according to the outcome: (1) nonsurvival (n=5): patients who died; (2) survival A (n=15): CSF sampled between 1st and 3rd day from patients who survived after hospital admission; and (3) survival B (n=7): CSF sampled between 4th and 7th day from patients who survived after hospital admission and were maintained with intraventricular catheter up to 7 days.
  
  
  RESULTS
  Up to 3 days, S100B and NSE levels (ng/mL) were significantly elevated in the nonsurvival compared with survival A group (S100: 12.45 ± 5.46 vs 5.64 ± 3.36; NSE: 313.20 ± 45.51 vs 107.80 ± 112.10). GFAP levels did not differ between groups. In the survival B group S100B, GFAP, and NSE levels were still elevated compared with control (4.59 ± 2.19, 2.48 ± 2.55, and 89.80 ± 131.10, respectively). To compare S100B and NSE for the prediction of nonsurvival and survival patients we performed receiver operating characteristic curves. At admission, CSF NSE level predicts brain death more accurately than S100B.
  
  
  CONCLUSIONS
  Early elevations (up to 3 days) of S100B and NSE secondary to severe TBI predict deterioration to brain death. However, this feature was more prominently associated with NSE than S100B.
authors.affiliation: Department of Biochemistry, ICBS, Federal University of Rio Grande do Sul, Porto, Alegre, RS, Brazil.
authors.forename: Ana Elisa
authors.initials: AE
authors.lastname: Böhmer
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Oses
authors.forename: André Prato
authors.initials: AP
authors.lastname: Schmidt
authors.forename: Cleiton Schweister
authors.initials: CS
authors.lastname: Perón
authors.forename: Claudio Liss
authors.initials: CL
authors.lastname: Krebs
authors.forename: Paulo Petry
authors.initials: PP
authors.lastname: Oppitz
authors.forename: Thiago Torres
authors.initials: TT
authors.lastname: D'Avila
authors.forename: Diogo Onofre
authors.initials: DO
authors.lastname: Souza
authors.forename: Luis Valmor
authors.initials: LV
authors.lastname: Portela
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Stefani
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D001930:Brain Injuries / Q000134:cerebrospinal fluid* / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015600:Glasgow Coma Scale; D005904:Glial Fibrillary Acidic Protein / Q000134:cerebrospinal fluid*; D006801:Humans; D008297:Male; D009414:Nerve Growth Factors / Q000134:cerebrospinal fluid*; D010751:Phosphopyruvate Hydratase / Q000134:cerebrospinal fluid*; D011379:Prognosis; D012372:ROC Curve; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000134:cerebrospinal fluid*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human; D010751:Phosphopyruvate Hydratase